The Washington Post - USA (2022-05-17)

TUESDAY, MAY 17 , 2022. THE WASHINGTON POST EZ EE E3

HEALTH NEWS

HEALTH SCAN

BY ERIN BLAKEMORE

Abortion. Transgender rights.
Maternal mortality. Many of
health’s most pressing issues are
intertwined with gender — and a
collaborative, peer-reviewed
project looks at the tangled roots
that connect our bodies to past
and present.
Group blog Nursing Clio,
which recently celebrated its
1 0-year anniversary, was founded
by a group of scholars with an
interest in the intersections of
gender, history and health.
It describes itself as “a gather-
ing site for historians, health care
workers, community activists,
students, and the public at large
to engage in discussion of current
and historical debates over medi-
cine and the gendered body.”
That broad and ambitious
scope lends itself to fascinating
and varied takes on everything
from war to obesity. Recent arti-
cles include historian Amanda
Brennan’s look at the term “hav-
ing it all” and its relationship to
abortion, eugenics and race; ar-
chivist Vicky Iglikowski-Broad’s

exploration of the history of men-

strual products in the United

Kingdom; and undergraduate

Jesse Morales’s article on diversi-

ty in children’s television and its

connections to mental health.

“The personal is historical,” the

blog’s authors declare — and its

lineup of historians and authors

proves that point again and

again.

The focus is serious, the blog

articles replete with footnotes

and quotes. Yet Nursing Clio

manages to be witty, immersive

and entertaining, even as it delves

into the history of some of soci-

ety’s most contentious issues.

That h istory is as long as that of

the human body, the blog sug-

gests. A visit to Nursing Clio

offers plenty to study, whether

you’re interested in academic top-

ics or just curious about how

gender, the body and history are

intertwined.

GENDER AND HISTORY

Peer-reviewed project examines tangled roots

that connect our bodies to the past and present

Abortion Rights and the Eugenic

and Racist Origins of Having It All

Nursing Clio

BY TONYA RUSSELL

A

recent social media

trend is raising aware-

ness — and perhaps

stoking fears — about a

relatively rare and po-

tentially debilitating condition

known as topical steroid with-

drawal (TSW).

As of mid-March, there had

been more than 168 million views

of TikTok videos with the hashtag

#topicalsteroidwithdrawal. They

show dramatic footage of people

— many of them young — with

red, cracked, scaling skin on their

faces, torsos and feet describing

the challenges of dealing with

this often painful condition. We

spoke with a dermatologist and a

family medicine practitioner for

a better understanding of TSW

and to put the condition into

perspective.

What is TSW?

Topical steroid withdrawal “is

a real and difficult-to-treat phe-

nomenon that can occur while

treating any chronic skin rash

with topical steroids,” says Jeffrey

S. Fromowitz, a dermatologist in

Boca Raton, Fla. (Topical steroids

are commonly used to treat ecze-

ma, as well as other skin condi-

tions, such as acne and psoriasis.)

“When the person seems to be

doing well and wants to stop

treating the rash, upon with-

drawal of the steroid medication,

the area previously treated can

become severely inflamed, some-

times even worse than the rash

that was being treated,” Fromow-

itz says.

Symptoms of TSW include red

skin that burns, stings, cracks,

peels, itches and displays pus-

filled bumps. These generally be-

gin to appear in the days and

weeks after ceasing steroid treat-

ment; recovery can take many

months. Research into the condi-

tion is in the early stages, and not

all dermatologists agree on the

causes of TSW, how to diagnose it

or even that it exists. (Some

doctors say topical steroid with-

drawal could be a flare-up of the

condition the steroids were being

used to treat.)

How common is it?

While the National Eczema

Association (NEA) reports that

the number of people affected by

TSW is difficult to determine, the

physicians we spoke with say that

few people who use topical ste-

roids will suffer from this compli-

cation. Michael Rogers, who

practices family medicine in New

Jersey, says that he frequently

treats eczema patients — many of

them with topical steroids — and

has only once in his 40-year

career seen a case of TSW. He says

it was a severe case in a patient

who had used topical steroids for

most of her life and discontinued

them when she decided to be-

come pregnant. “It took a year for

her symptoms to improve,” Rog-

ers says.

Who is most at risk?

According to the NEA, a review

of medical literature on topical

steroid withdrawal suggests that

individuals who use topical ste-

roids for extended, uninterrupted

periods and who increase the

amount and potency of the medi-

cation over time are most suscep-

tible. “Typically, the higher the

potency of the medication, the

more likely this condition is to

occur,” Fromowitz says. A 2015

review published in the Journal

of the American Academy of Der-

matology found that most report-

ed cases were among women,

with relatively few cases among

patients ages 18 and younger. The

face was the part of the body most

prone to developing a rash or

peeling from TSW.

Reducing the problem

The surest way to avoid TSW is

to not use topical steroids to treat

eczema or other skin conditions,

Fromowitz says, adding that they

are the only thing that provides

relief for many with severe ecze-

ma. According to the NEA web-

site, topical steroids are effective

and inexpensive, and they have

been used to treat eczema for

more than 50 years. Fromowitz

says that a board-certified derma-

tologist can help a patient devel-

op strategies to minimize the

risk, including limiting the dura-

tion of steroid use or lowering the

strength of the medication. “In

recent years there have been non-

steroidal topical alternatives”

that are approved by the Food

and Drug Administration to treat

eczema rashes, without the risk of

TSW, he says.

Rogers recommends steps

many people with mild to moder-

ate eczema can take to help mini-

mize symptoms on their own: “I

tell the average eczema patient in

the wintertime to stop with the

long showers. The warmer the

water the better it feels, but

warmer water dries out the skin

and tends to make it worse.” For

those with a severe case of ecze-

ma, he recommends even turning

the water off, lathering up, then

turning it back on only to rinse.

For those who are on topical

steroids, he recommends “wet

wrap therapy,” or placing a warm,

damp cloth over the area to aid in

absorption. According to the

NEA, this can help the topical

medications work better.

FROM CONSUMER REPORTS

The trouble with steroid creams

TIM GRIST/GETTY IMAGES

A tube of hydrocortisone cream, a steroid medicine that can treat skin conditions and other ailments.

Consumer Reports is an

independent, nonprofit organization

that works side by side with

consumers to create a fairer, safer,

and healthier world. CR does not

endorse products or services, and

does not accept advertising. CR has

no financial relationship with

advertisers in this publication. Read

more at ConsumerReports.org.

3.4

million

Roughly 3.4 million U.S. residents will be
diagnosed with skin cancer in 2022,
according to estimates compiled by the
American Cancer Society and the
American Society of Clinical Oncologists.
The vast majority (3.3 million) will have
basal cell or squamous cell carcinoma,
while the others (99,780 people) will
have melanoma — the less common but
more dangerous type of skin cancer. Cancer experts predict that
7,650 residents will die of melanoma this year. Overall, about
20 percent of Americans develop skin cancer at some point in their
lifetime — men more often than women, but women generally at a
younger age than men. Anyone can develop skin cancer, regardless
of skin color. Skin cancer ranks as the most common cancer in the
United States, but it also is considered the most preventable. Most of
the time, skin cancer develops because of overexposure to ultraviolet
(UV) rays, either from the sun or from an artificial source such as a
sun lamp or tanning bed. UV rays damage skin cells, causing
abnormal cells to form, rapidly divide and spread. Treatment varies
by a skin cancer’s type and stage, but common methods include
surgery to shave or cut away the cancerous tissue or freezing (known
as cryosurgery) to destroy the tissue. Preventing the development of
skin cancer starts by protecting the skin from UV rays. According to
the American Academy of Dermatology, that means avoiding indoor
tanning and, when outdoors, seeking shade whenever possible,
wearing protective clothing, sunglasses and a wide-brimmed hat,
and applying a broad-spectrum, water-resistant sunscreen with a
sun protection factor (SPF) of 30 or higher to all skin not covered by
clothing. All exposure to UV rays — not just sunburn and blistering
but tanning, too — can lead to skin cancer.
— Linda Searing

BIG NUMBER

BY DREW COSTLEY

Climate change will result in

thousands of new viruses spread

among animal species by 2070 —

and that will probably increase

the risk of emerging infectious

diseases jumping from animals to

humans, according to a study.

This is especially true for Afri-

ca and Asia, continents that have

been hot spots for deadly disease

spread from humans to animals

or vice versa over the past several

decades, including the flu, HIV,

Ebola and the coronavirus.

Researchers, who published

their findings last month in the

journal Nature, used a model to

examine how over 3,000 mammal

species might migrate and share

viruses over the next 50 years if

the world warms by 2 degrees

Celsius (3.6 degrees Fahrenheit),

which recent research shows is

possible.

They found that cross-species

virus spread will happen over

4,000 times among mammals

alone. Birds and marine animals

weren’t included in the study.

Researchers said not all viruses

will spread to humans or become

pandemics the scale of the coro-

navirus — but the number of

cross-species viruses increases

the risk of spread to humans.

The study highlights two glob-

al crises — climate change and

infectious-disease spread — as

the world grapples with what to

do about both.

Previous research has looked

at how deforestation and extinc-

tion, and wildlife trade lead to

animal-human disease spread,

but there is less research about

how climate change could influ-

ence this type of disease trans-

mission, the researchers said at a

recent news briefing.

“We don’t talk about climate a

lot in the context of zoonoses” —

diseases that can spread from

animals to people, said study

co-author Colin Carlson, an assis-

tant professor of biology at

Georgetown University. “Our

study... brings together the two

most pressing global crises we

have.”

Experts on climate change and

infectious disease agreed that a

warming planet will probably

lead to increased risk for the

emergence of new viruses.

Daniel R. Brooks, a biologist at

University of Nebraska State Mu-

seum and co-author of the book

“The Stockholm Paradigm: Cli-

mate Change and Emerging Dis-

ease,” said the study acknowledg-

es the threat posed by climate

change in terms of increasing risk

of infectious diseases.

“This particular contribution

is an extremely conservative esti-

mate for potential” emerging

i nfectious-disease spread caused

by climate change, Brooks said.

Aaron Bernstein, a pediatri-

cian and interim director of the

Center for Climate, Health, and

the Global Environment at Har-

vard T.H. Chan School of Public

Health, said the study confirms

long-held suspicions about the

effect of warming on infectious-

disease emergence.

“Of particular note is that the

study indicates that these en-

counters may already be happen-

ing with greater frequency and in

places near where many people

live,” Bernstein said.

Study co-author Gregory Al-

bery, a disease ecologist at

Georgetown University, said that

because climate-driven

i nfectious-disease emergence is

probably already happening, the

world should be doing more to

learn about and prepare for it.

“It is not preventable, even in

the best case climate change sce-

narios,” Albery said.

Carlson, who was also an au-

thor on the latest report from the

Intergovernmental Panel on Cli-

mate Change, said we must cut

greenhouse gas and phase out

fossil fuels to reduce the risk of

infectious-disease spread.

Jaron Browne, organizing di-

rector of the climate justice group

Grassroots Global Justice Alli-

ance, said the study highlights

climate injustices experienced by

people living in African and Asian

nations.

“A frican and Asian nations face

the greatest threat of increased

virus exposure, once again illus-

trating how those on the front

lines of the crisis have very often

done the least to create climate

change,” Browne said.

— Associated Press

Study: Rise in infectious diseases linked to climate

SETH PINCUS, ELIZABETH FISCHER, AUSTIN ATHMAN/ASSOCIATED PRESS

This colorized electron microscope image shows a human T cell, in

blue, under attack by HIV, the virus that causes AIDS, in yellow.

BY CARLA K. JOHNSON

A rare but aggressive kind of
uterine cancer appears to be driv-
ing an increase in U.S. deaths
from the disease, particularly
among Black women, researchers
reported this month.
Over eight years, deaths from
the aggressive type rose by
2.7 percent per year, while deaths
were stable for the less aggressive
kind, their study found. Black
women had more than twice the
rate of deaths from uterine can-
cer overall, and of the more
aggressive type, when compared
with other racial and ethnic
groups.
The aggressive kind — called
Type 2 endometrial cancer — is
more difficult to treat. By the end
of the study period, it accounted
for about 20 percent of cases and
45 percent of deaths.
“For most cancers, there have
been improvements over the last
20 years. It’s alarming that we
haven’t had the same success
with uterine cancer,” said Pamela
Soliman of MD Anderson Cancer
Center in Houston, who was not
involved in the study.
“This allows us to focus our
efforts on specific areas that
could potentially have a bigger
impact on mortality,” Soliman
said.

An estimated 65,950 new cases

of uterine cancer will be diag-

nosed in the United States this

year and 12,550 women are ex-

pected to die of it. Irregular

bleeding can be a warning sign,

but there is no recommended

screening test.

Researchers analyzed U.S. can-

cer data for women 40 and older.

They found overall uterine can-

cer death rates increased by

1.8 percent per year from 2010 to

2017.

Annual rates increased 3.4 per-

cent among Asian women,

3.5 percent among Black women,

6.7 percent among Hispanic

women and 1.5 percent among

White women. (The researchers

adjusted for hysterectomy rates,

which vary by race. Women who

have had their wombs removed

cannot get uterine cancer.)

Obesity is a risk factor for the

less aggressive uterine cancer,

but there is no clear risk factor for

the more aggressive kind, said

the National Cancer Institute’s

Megan Clarke, who led the study,

published in the journal JAMA

Oncology.

“We think it is something that

is more common in Black women

and increasing in the population

for all women,” Clarke said. “It’s

very puzzling and concerning.”

— Associated Press

Research discovers clues to ‘very puzzling and

concerning’ rise in uterine cancer death rates

CENTERS FOR DISEASE CONTROL AND PREVENTION/ASSOCIATED PRESS

A microscopic image from a Pap test that shows a positive
indication for the presence of uterine cervical adenocarcinoma.

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HEALTH & SCIENCE

DO YOU HAVE

HEART DISEASE OR

TYPE 2 DIABETES?

Researchers at NIH seek patients to learn how inflammation

plays a role in the development of cardiovascular disease.

Study participation is free and compensation is provided.

For more information, please see complete study information here:

https://go.usa.gov/xQWqE Or email: [email protected]

You may be eligible to participate

in this study if you:

• Are 18 years of age or older


• Have type 2 diabetes or risk factors for
  cardiovascular disease
  You may NOT participate
  in this study if you:


• Are pregnant or breastfeeding


• Have a history of bleeding disorder or
  taking anti-coagulation medication


• Currently undergoing cancer treatment

What is involved:

• Blood draws, clinic
  visit, EKG, and brief
  questionnaires


• PET CT and/or MRI scans
  to assess for chronic
  inflammation


• CT scan of heart, which can
  detect plaque formation in
  the blood vessels

To learn more, please contact the NIH Clinical Center Office of Patient

Recruitment at 1-800-411-12 22 and reference study #13-H-0194